Abstract
Zidovudine was the first agent approved for treatment of HIV disease, and since its widespread availability in 1987, the pharmacokinetic disposition and clinical effects of ZDV have been extensively evaluated. In addition to its utility as a component of a multidrug combination regimen for the treatment of adult and pediatric HIV-1 infection, it is the only agent approved by the FDA for the prevention of mother-to-child HIV-1 transmission. The effectiveness of ZDV for the prevention of mother-to-child HIV-1 transmission has been demonstrated in several studies. The optimal time during gestation to initiate ZDV therapy and the relative importance of the intrapartum and newborn components is the focus of both current interventional and observational studies. Until more information is available from these trials, the combined maternal/newborn ZDV regimen studied in ACTG 076 remains the recommended treatment regimen of choice in the United States.
Full Text
The Full Text of this article is available as a PDF (537.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Acosta E. P., Page L. M., Fletcher C. V. Clinical pharmacokinetics of zidovudine. An update. Clin Pharmacokinet. 1996 Apr;30(4):251–262. doi: 10.2165/00003088-199630040-00001. [DOI] [PubMed] [Google Scholar]
- Acosta E. P., Schwebke K., Henry K., Fletcher C. V. Disposition of zidovudine in obese pregnant women with human immunodeficiency virus type 1 infection. J Infect Dis. 1996 Sep;174(3):673–673. doi: 10.1093/infdis/174.3.673. [DOI] [PubMed] [Google Scholar]
- Ayers K. M., Torrey C. E., Reynolds D. J. A transplacental carcinogenicity bioassay in CD-1 mice with zidovudine. Fundam Appl Toxicol. 1997 Aug;38(2):195–198. doi: 10.1006/faat.1997.2342. [DOI] [PubMed] [Google Scholar]
- Carpenter C. C., Fischl M. A., Hammer S. M., Hirsch M. S., Jacobsen D. M., Katzenstein D. A., Montaner J. S., Richman D. D., Saag M. S., Schooley R. T. Antiretroviral therapy for HIV infection in 1998: updated recommendations of the International AIDS Society-USA Panel. JAMA. 1998 Jul 1;280(1):78–86. doi: 10.1001/jama.280.1.78. [DOI] [PubMed] [Google Scholar]
- Connor E. M., Sperling R. S., Gelber R., Kiselev P., Scott G., O'Sullivan M. J., VanDyke R., Bey M., Shearer W., Jacobson R. L. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1994 Nov 3;331(18):1173–1180. doi: 10.1056/NEJM199411033311801. [DOI] [PubMed] [Google Scholar]
- Eastman P. S., Shapiro D. E., Coombs R. W., Frenkel L. M., McSherry G. D., Britto P., Herman S. A., Sperling R. S. Maternal viral genotypic zidovudine resistance and infrequent failure of zidovudine therapy to prevent perinatal transmission of human immunodeficiency virus type 1 in pediatric AIDS Clinical Trials Group Protocol 076. J Infect Dis. 1998 Mar;177(3):557–564. doi: 10.1086/514228. [DOI] [PubMed] [Google Scholar]
- Fischl M. A., Richman D. D., Grieco M. H., Gottlieb M. S., Volberding P. A., Laskin O. L., Leedom J. M., Groopman J. E., Mildvan D., Schooley R. T. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med. 1987 Jul 23;317(4):185–191. doi: 10.1056/NEJM198707233170401. [DOI] [PubMed] [Google Scholar]
- Fiscus S. A., Adimora A. A., Schoenbach V. J., Lim W., McKinney R., Rupar D., Kenny J., Woods C., Wilfert C. Perinatal HIV infection and the effect of zidovudine therapy on transmission in rural and urban counties. JAMA. 1996 May 15;275(19):1483–1488. [PubMed] [Google Scholar]
- Frenkel L. M., Wagner L. E., 2nd, Demeter L. M., Dewhurst S., Coombs R. W., Murante B. L., Reichman R. C. Effects of zidovudine use during pregnancy on resistance and vertical transmission of human immunodeficiency virus type 1. Clin Infect Dis. 1995 May;20(5):1321–1326. doi: 10.1093/clinids/20.5.1321. [DOI] [PubMed] [Google Scholar]
- Krauer B., Krauer F., Hytten F. E. Drug disposition and pharmacokinetics in the maternal-placental-fetal unit. Pharmacol Ther. 1980;10(2):301–328. doi: 10.1016/0163-7258(80)90085-6. [DOI] [PubMed] [Google Scholar]
- Liebes L., Mendoza S., Wilson D., Dancis J. Transfer of zidovudine (AZT) by human placenta. J Infect Dis. 1990 Feb;161(2):203–207. doi: 10.1093/infdis/161.2.203. [DOI] [PubMed] [Google Scholar]
- Matheson P. B., Abrams E. J., Thomas P. A., Hernán M. A., Thea D. M., Lambert G., Krasinski K., Bamji M., Rogers M. F., Heagarty M. Efficacy of antenatal zidovudine in reducing perinatal transmission of human immunodeficiency virus type 1. The New York City Perinatal HIV Transmission Collaborative Study Group. J Infect Dis. 1995 Aug;172(2):353–358. doi: 10.1093/infdis/172.2.353. [DOI] [PubMed] [Google Scholar]
- Mauskopf J. A., Paul J. E., Wichman D. S., White A. D., Tilson H. H. Economic impact of treatment of HIV-positive pregnant women and their newborns with zidovudine. Implications for HIV screening. JAMA. 1996 Jul 10;276(2):132–138. [PubMed] [Google Scholar]
- O'Sullivan M. J., Boyer P. J., Scott G. B., Parks W. P., Weller S., Blum M. R., Balsley J., Bryson Y. J. The pharmacokinetics and safety of zidovudine in the third trimester of pregnancy for women infected with human immunodeficiency virus and their infants: phase I acquired immunodeficiency syndrome clinical trials group study (protocol 082). Zidovudine Collaborative Working Group. Am J Obstet Gynecol. 1993 May;168(5):1510–1516. doi: 10.1016/s0002-9378(11)90791-1. [DOI] [PubMed] [Google Scholar]
- Reynolds F., Knott C. Pharmacokinetics in pregnancy and placental drug transfer. Oxf Rev Reprod Biol. 1989;11:389–449. [PubMed] [Google Scholar]
- Sperling R. S., Roboz J., Dische R., Silides D., Holzman I., Jew E. Zidovudine pharmacokinetics during pregnancy. Am J Perinatol. 1992 Jul;9(4):247–249. doi: 10.1055/s-2007-994781. [DOI] [PubMed] [Google Scholar]
- Sperling R. S., Shapiro D. E., Coombs R. W., Todd J. A., Herman S. A., McSherry G. D., O'Sullivan M. J., Van Dyke R. B., Jimenez E., Rouzioux C. Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1996 Nov 28;335(22):1621–1629. doi: 10.1056/NEJM199611283352201. [DOI] [PubMed] [Google Scholar]
- Sperling R. S., Shapiro D. E., McSherry G. D., Britto P., Cunningham B. E., Culnane M., Coombs R. W., Scott G., Van Dyke R. B., Shearer W. T. Safety of the maternal-infant zidovudine regimen utilized in the Pediatric AIDS Clinical Trial Group 076 Study. AIDS. 1998 Oct 1;12(14):1805–1813. doi: 10.1097/00002030-199814000-00012. [DOI] [PubMed] [Google Scholar]
- Watts D. H., Brown Z. A., Tartaglione T., Burchett S. K., Opheim K., Coombs R., Corey L. Pharmacokinetic disposition of zidovudine during pregnancy. J Infect Dis. 1991 Feb;163(2):226–232. doi: 10.1093/infdis/163.2.226. [DOI] [PubMed] [Google Scholar]